New guidance issued by NHS England on the use of single-sex wards and facilities may increase risks of delayed care and "corridor care" for transgender patients, according to an internal impact assessment. The report, reviewed in advance of the policy’s rollout, highlights concerns that the updated rules could affect the timeliness and quality of healthcare received by trans individuals.
The guidance, released on Thursday, directs NHS trusts to allocate single-sex wards, toilets, and changing rooms based on biological sex rather than gender identity. This follows a 2025 ruling by the UK Supreme Court clarifying that terms such as “woman” and “sex” in the Equality Act apply strictly to biological definitions and do not extend to transgender women holding gender recognition certificates.
The internal NHS England assessment examined the implications of the policy across various protected characteristics, including age, disability, and sex. While it acknowledged that the approach may enhance privacy, dignity, and safety for men and women in the context of single-sex spaces, it also flagged significant potential drawbacks for transgender patients.
Among the concerns detailed in the report were possible delays in accessing appropriate care spaces and an increased likelihood of transgender patients being placed in “corridor care,” where lack of available side rooms forces patients to remain in non-ideal settings. Such circumstances, the document cautioned, could negatively affect both the physical and mental health outcomes of trans individuals.
Moreover, the assessment warned that the policy might hinder efforts to foster positive relations between cisgender and transgender patients. Staff managing ward placements could face challenges balancing the differing needs of these groups, potentially leading to friction and division.
The Equality and Human Rights Commission’s updated code of practice on services noted that transgender people are likely to be disadvantaged compared with cisgender individuals under the new framework. It emphasized that the provision of same-sex accommodation should not serve as justification for “corridor care,” advocating for decisions on where to place transgender patients to be made on a case-by-case basis.
NHS England did not provide a comment on the findings or the guidance when approached. The new policy marks a significant shift in the NHS approach to single-sex spaces, reflecting legal interpretations that have sparked debate around the rights and care of transgender patients within the healthcare system.